Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 63627 | CT |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 63627 | CT |
NPI | 1194161604 |
---|---|
Provider Name | Dr. Stephen Nelson |
First Address | Hamden, CT 06518-3209 |
Second Address | Hamden, CT 06518-3249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2013 |
Last Update Date | 23/07/2021 |